Provider Demographics
NPI:1861078883
Name:TIANO PHYSICAL THERAPY AND WELLNESS, INC.
Entity type:Organization
Organization Name:TIANO PHYSICAL THERAPY AND WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:TIANO
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:661-414-2522
Mailing Address - Street 1:30030 SUNRIDGE PL
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-1500
Mailing Address - Country:US
Mailing Address - Phone:661-414-2522
Mailing Address - Fax:
Practice Address - Street 1:30030 SUNRIDGE PL
Practice Address - Street 2:
Practice Address - City:CANYON COUNTRY
Practice Address - State:CA
Practice Address - Zip Code:91387-1500
Practice Address - Country:US
Practice Address - Phone:661-414-2522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-21
Last Update Date:2021-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty